Onco Professional Services provides Management, Quality Control, Abstracting, Casefinding, and Follow-Up to help facilities achieve their goals. Periodically, our Onco Professional Services Staff share education and training documents internally on various topics related to the Cancer Registry; we call these bite-sized educational topics, “Did You Knows?”. Did You Knows are a valuable resource for our team, helping our staff stay up to date on registry-related topics. Going forward, we will share some of these via our blog periodically. We hope you find them as beneficial as our team does.
Background: Often topography related to the testis is missing from physician documentation. Today’s “Did You Know” will address how to determine the best code.
Did You Know: When to use Testis Undescended (C62.0) vs Testis Descended (C62.1) vs Testis NOS (C62.9)
Information: We rarely see documentation from physicians describing the testis as descended or undescended. That appears to leave Testis NOS as the only option. But does it?
The following comments are from SEER Inquiry but are considered still valid: 20140005
Question: Primary site–Testis: In the absence of a specific statement that the patient’s testicle(s) are descended, should the primary site for a testicular tumor be coded as C621 (Descended Testis) when the mass is palpable on physical exam or demonstrated on scrotal ultrasound? See discussion.
Discussion: It seems the non-specific Testis, NOS (C629) code is being overused. Many testis cases have no documentation of the patient’s testicular descension. However, testicular tumors in adults are frequently detected by palpation or scrotal ultrasound. An undescended testis (a testis absent from the normal scrotal position) would be non-palpable or not amenable to imaging via a scrotal ultrasound.
Answer: Unless the testicle is stated to be undescended, it is reasonable to code C621 for primary site. Reserve C629 for cases with minimal or conflicting information.
Examples of when to use C62.0, C62.1, and C62.9
Example 1: A patient has abdominal symptoms that lead to a work-up. Physical exam and scans may indicate the presence of testis in the abdomen and lack of presence in the scrotal sac. It may also be referred to as impalpable testicle. Primary Site is C62.0
Example 2: A patient notes a testicular mass on self-exam. Work-up with physical exam and ultrasound/scans indicate there is palpable mass involving the testis in the scrotal sac. Primary Site is C62.1
Example 3: A patient was diagnosed at an outside facility with testicular malignancy and treated with surgery. They present to the current facility for adjuvant therapy evaluation. Outside records are not available and the current physician does not note the anatomic location of the surgery. No further information is available. Primary Site is C62.9
Reference(s): SEER Inquiry & The Missouri Cancer Registry and Research Center Show-Me-Tips December 2023 has additional good information regarding Testicular Cancer. 25_ShowMeTips_2023-Testis_12-23.pdf (missouri.edu)
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